WHAT IS THE ORAL MICROBIOME?

A look at the oral microbiome, why it is so important for our overall body health and how you can help keep it in optimum condition

A healthy mouth can mean a healthy body!

What is the oral microbiome?

You have probably heard a huge amount about the gut microbiome, it has become one of the most talked about subjects and there is a huge amount of exciting research going on to discover exactly what part it may play in certain illnesses and how it can affect our moods and mental health and even cause anxiety and depression.

What about the oral microbiome though? This area of health has not been covered as widely but our mouth is a gateway to the rest of the body. Inside the mouth there is a living world of bacteria working away to try and keep the mouth, gums and teeth healthy. It gets a lot of abuse with smoking, vaping, food, alcohol, hot drinks and even mouthwash, many of which also contain alcohol. All these things can disrupt the balance of good bacteria/bad bacteria (the oral microbiome) in the mouth and weaken our oral defences, possibly leading to bad breath, sore patches or gum disease. As we get older the mouth can also become a lot drier causing problems for some people and medical treatments such as chemotherapy can cause their own issues with the mouth such as sensitivity, dryness and ulcers.

The importance of dental hygiene

Did you know that disease in the mouth can also affect many other parts of your body too?

Gum disease is usually caused by bacteria from the build up of plaque on the teeth. In cases of extreme inflammation it is believed that it can also affect the bloodstream and slowly damage blood vessels in the heart and brain over a period of time.

In your mouth a mixture of bacteria, proteins and saliva cover your teeth in a very thin layer most of the time. Small particles of sugars and acids from the food and drink you consume will stick to this film and over time it will build up into what is known as plaque. It is the bacteria that live on the plaque that can cause gum disease but of course brushing your teeth and flossing or using interdental sticks will help remove the plaque and prevent the build up.

"The link between oral health and overall body health is well documented and backed by robust scientific evidence. Despite this, only 1 in 6 people realises that people with gum disease may have an increased risk of stroke or diabetes. And only 1 in 3 is aware of the heart disease link." - Dr Nigel Carter, Chief Executive - British Dental Foundation

Good bacteria in the mouth

So if bad bacteria in the mouth can affect your overall health, it makes sense to look after your oral microbiome and encourage the good bacteria that live there. This also has the knock on effect of helping keep your breath fresh and avoiding nasty tastes in the mouth.

You can help with this by not consuming too much sugary food and drink, not smoking or vaping and not using a mouthwash that contains alcohol. You can also help the oral microbiome by using a gentle toothpaste without harsh cleaning ingredients such as sodium lauryl sulfate (SLS) which will also encourage an environment where the good bacteria can flourish.

I have spent quite a bit of time looking at toothpastes. When I had chemotherapy it gave me the most dreadfully sore mouth. I literally had so many mouth ulcers that I could barely put water in it because the pain was unbearable. At the time I changed from a standard toothpaste, which caused great pain and stinging, to a natural one which did help. Most standard toothpastes contains some quite harsh cleaning agents such as SLS (sodium lauryl sulfate) or antibacterial and antifungal agents such as tricolsan (for further information on the dangers of triclosan see What is Clean Beauty Part II - 15 ingredients to try and avoid in your skincare and makeup) which can strip the delicate areas in the mouth, killing your good bacteria and making you more prone to soreness and ulcers, and in theory also gum disease. It makes sense that you don't want to kill all the bacteria in your mouth, particularly the good stuff!

So why doesn't everyone use a natural toothpast then? The trouble with a lot of natural toothpastes is that they do not contain any fluoride. I know there are many arguments out there for avoiding fluoride (which is a naturally occurring mineral) but it does help protect the enamel on the teeth and help prevent tooth decay. The issues and dangers with fluoride come from over-consumption orally, so as long as you are not swallowing the toothpaste (which is why children should always be supervised when they brush their teeth) and rinse your mouth out thoroughly after brushing, I don't think you don't need to be overly worried about fluoride in toothpaste, unless you get a reaction from using it.

Some people don't think that a natural toothpaste (without without fluoride) gets the teeth clean or leaves their breath smelling fresh, but believe me, there are some really effective natural toothpastes out there and some of them knock the spots off standard ones!

Sodium lauryl sulfate toothpaste side effects

Sodium lauryl sulfate is quite a harsh foaming agent used in most toothpastes. A lot of people don't have any problems with it, or may only notice an issue when their mouth health is under par, for instance if they have a mouth ulcer or thrush infection in the mouth.

I have an issue with most toothpastes that contain sodium lauryl sulfate in that it seems to strip my mouth of the natural sikly feeling you get when you feel the sie if your cheek with your tongue and it also somethimes make the tiny nodules on my tongue swell up slightly and sometimes I can't tase food properly either. All in all my tongue and mouth don't feel at all comfortable if I use a toothpaste containing SLS and it is a very hard feeling to describe. A bit like my tongue being a bit too big for my mouth and it can also make me lisp very slightly if it's really bad!

Because of this I tend to use natural toothpastes, both with and without fluoride. I tend to use one in the morning and the other at night so I get some fluoride every day.

If you have any discomfort in your mouth in any way, it might just be worth trying a natural toothpaste to see if you can relieve it. I have found it usually takes about a week to get rid of all the problems, so not very long at all.

Fluoride free toothpaste

I've tried lots of good fluoride free toothpastes and here are just a couple of my favourites which were really effective at cleaning my teeth and leaving my mouth feeling fresh.

a natural toothpaste with a strong mint kick!

The toothpaste that I use when I want to brush with a completely natural product is the Aloe Dent aloe vera triple action charcoal toothpaste - it's way better than it sounds! It looks a bit odd as it is a black toothpaste but it has a good whitening effect on the teeth due to the addition of the silica, activated charcoal and Icelandic moss. I was somewhat sceptical about the whitening but have to say that it works really well. The toothpaste is completely free from SLS and tricolsan and is mild on the delicate areas of the mouth but also has a strong mint flavour for those people who often find that a natural toothpaste can be a bit bland and miss the 'hit' they get from a conventional toothpaste or want an extra 'fresh breath' feel.

Ingredients: glycerin, aloe barbadensis leaf juice, sorbitol, hydrated silica, aqua, sodium lauroyl sarcosinate, mentha piperita (peppermint) oil, cetaria islandica (Icelandic moss) extract, hydroxyethycellulose, menthol, xyitol, stevia rebaudiana (stevia)extract, melaleuca alternifolia (tea tree) leaf oil, escin, phenoxyethanol, sodium benzoate, potassium sorbate, citric acid, charcoal powder (activated), benzyl alcohol (not derived from ethanol), limonene (natural constituent of essential oils).

The aloe vera helps soothe the gums, the tea tree oil acts as a natural antiseptic, the silica and Icelandic moss are for whitening, the stevia is a natural sweetener, the escin (derived from horse chestnut) is anti-inflammatory and helps maintain healthy gums. The activated charcoal naturally whitens and removes impurities and the menthol is there for natural flavour. Aloe Dent do a variety of toothpaste options such as sensitive, whitening fluoride free, whitening with fluoride, children's.

AloeDent triple action charcoal toothpaste is suitable for vegetarians and vegans and a 100ml tube costs about £4.99. It is available from many good chemists such as Boots, some Holland and Barret stores and online from Amazon or optimah.com (who make the AloeDent range).

a great natural whitening toothpaste

I also like the black whitening toothpaste from Ecodenta. This is minty but I would say not as strong as the AloeDent one above, but it still gives you a fresh mouth, so would be good if you like a minty taste but not too strong. It cleans very well and removes the build up that I can feel on the sides of my teeth, particularly at the back of my mouth.

Ingredients: Aqua*, Glycerin*, Hydrated Silica*, Sorbitol*, Sodium Cocoyl Glutamate*, Aroma, Sodium Pyrophosphate, Charcoal Powder*, Epigallocatechin Gallate*, Mentha Arvensis (Mint) Oil*, Xanthan Gum*, Sodium Benzoate, Potassium Sorbate, Phenoxyethanol, Ethylhexylglycerin, Sodium Saccharin, CI 77499, CI 77266.

The activated charcoal helps to whiten the teeth and it is also said to have mild anti-bacterial qualities. The mint oil helps the mouth feel fresh and clean too and they also have a unique ingredient that they have trade mareked as 'teavigo' on the packaging. The teavigo is a green tea extract that helps protect against tartar.

Natural toothpaste with fluoride

an SLS and triclosan free toothpaste but with fluoride

I was also keen to try a gentle toothpaste with fluoride. Dentists recommend that a toothpaste has at least 1450ppm of fluoride or it won't be good enough to protect the teeth. I came across a toothpaste called Zendium that has been developed without SLS and tricolsan but with natural enzymes and proteins. As an additional benefit it claims to boost the good bacteria in the mouth whilst reducing the bad bacteria (dental plaque data on bacterial species showing significant change in a 14 week clinical study with 102 subjects). The company claim that it will help strengthen the natural defences in the mouth and work with the body boosting the naturally protective bacteria without the need for harsh or aggressive ingredients, giving a more balanced oral microbiome in 14 weeks. It is also 4 x gentler on the mouth than a standard toothpaste and has the required 1450ppm of fluoride.

I have been using Zendium gentle whitening toothpaste for quite a while now and am impressed with it. Some people do not appear to have any problems with standard toothpaste but I don't like the slightly burning feeling that some toothpastes have. Zendium works and tastes just like any other toothpaste I have used. My mouth feels clean and fresh and it appears to get rid of the plaque build up. The skin on my cheeks is more 'slippy' and soft (as it should be) and there is no burning feeling afterwards. It is a white toothpaste and has a mild mint taste, it is quite subtle but my mouth feels fresh after using it. The whitening level is good too, coping with my strong coffee and tea habit!

Ingredients: aqua, hydrated silica, sorbitol, glycerin, steareth-30, disodium pyrophosphate, disodium phosphate, xanthan gum, aroma, carrageenan, sodium fluoride, sodium benzoate, amyloglucosidase, zinc gluconate, sodium saccharin, glucose oxidase, potassium thiocynate, lysozyme, colostrum, lactoferrin, lactoperoxidase, citric acid, CI 77891

Zendium hits the spot for being more natural and less harsh than a standard toothpaste but still having the protection of fluoride. It does contain egg and milk proteins so would not be suitable for vegans. Zendium do a full range of toothpastes such as complete protection, sensitive, gentle whitening, kids 1 - 6 for milk teeth and junior 7+ so there should be one suitable for all members of the family. Zendium Natural Whitening costs approx £4.00 for 75ml and is available at many place including Boots and online at sites such as Amazon and Feel Unique.

I'm very happy with the performance of the three natural toothpastes that I have mentioned above, although I have tried some others which didn't do too well! As a bonus, the whitening toothpastes do work and they didn't make my teeth sensitive like some standard whitening toothpastes do.

You may be interested in my review of Ben and Anna's Fluoride Free Natural Whitening Toothpaste.

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